Practice Question
The nurse is caring for a client who just received a diagnosis of gestational diabetes. The client states, "I don't understand why this happened. Why did I develop this?" How should the nurse respond? (Select all that apply.)
Answer Choices:
Correct Answer:
"Clients who have a first-degree relative with diabetes are at greater risk."
Rationale:
🌟 Correct Answer — “Clients who have a first-degree relative with diabetes are at greater risk.”
🌟 A first-degree relative (parent, sibling) with diabetes significantly increases the client’s risk of developing gestational diabetes mellitus (GDM) because of shared genetic patterns that influence insulin resistance.
🌟 Research shows that individuals with this family history have higher baseline metabolic susceptibility, making glucose intolerance more likely once pregnancy hormones increase insulin resistance.
🌟 This information helps reassure the client that the diagnosis is not due to personal failure, but rather a predictable genetic predisposition.
🌟 Family history is one of the strongest predictors of both type 2 diabetes and GDM.
🌟 When pregnancy hormones such as human placental lactogen raise insulin resistance, genetically predisposed clients are unable to compensate with increased insulin production.
🌟 Sharing this explanation helps the client understand the biological mechanism behind their diagnosis.
🌟 Correct Answer — “Clients who have a history of gestational diabetes are at greater risk.”
🌟 A prior history of gestational diabetes greatly increases the risk of recurrence because the underlying problem—insulin resistance—remains part of the client’s metabolic profile.
🌟 When the body is challenged again during pregnancy, the same physiologic pathway reactivates, often leading to elevated glucose levels.
🌟 This explanation helps the client understand that their diagnosis is related to pregnancy-specific changes rather than new disease.
🌟 Studies show that recurrence rates can be as high as 40–70% depending on maternal weight and genetics.
🌟 Educating the client about this risk highlights the importance of monitoring glucose levels earlier in future pregnancies.
🌟 This option accurately reflects clinical practice and confirmed risk factors.
🌟 Correct Answer — “Clients who have a history of polycystic ovary syndrome are at greater risk.”
🌟 Polycystic ovary syndrome (PCOS) is strongly associated with chronic insulin resistance, which directly increases the likelihood of gestational diabetes.
🌟 Clients with PCOS often have hormonal imbalances and metabolic dysfunction that impair how their bodies respond to insulin.
🌟 When pregnancy hormones further increase insulin resistance, these clients are more likely to exceed normal glucose levels.
🌟 This explanation helps clarify that the client’s risk stems from an underlying endocrine condition rather than lifestyle fault.
🌟 PCOS-related insulin resistance persists even when symptoms improve, making it a reliable predictor of GDM.
🌟 This is a physiologically accurate and evidence-supported risk factor.
🌟 Incorrect Answer — “Clients who have a history of cardiac disease are at greater risk.”
🌟 Cardiac disease does not increase the risk of developing gestational diabetes, because the two conditions affect different body systems.
🌟 Heart disease influences circulation and cardiac workload but does not alter insulin sensitivity or glucose metabolism.
🌟 Including this factor would give the client incorrect information about the cause of their diagnosis.
🌟 Risk factors must relate specifically to glucose intolerance or insulin resistance, which cardiac conditions do not cause.
🌟 Therefore, this option is not supported by obstetric or endocrine guidelines.
🌟 Incorrect Answer — “Clients with a BMI ≥ 20 are at greater risk.”
🌟 A BMI of 20 is considered completely normal and does not increase the risk for GDM.
🌟 Increased risk occurs when BMI is ≥ 25, and especially ≥ 30, where insulin resistance is significantly more pronounced.
🌟 Telling the client that BMI 20 increases risk would be inaccurate and may cause unnecessary guilt.
🌟 Only overweight and obese BMI categories are associated with impaired glucose tolerance in pregnancy.
🌟 Therefore, this option is factually incorrect.
🌟 Incorrect Answer — “Clients older than 20 years are at greater risk.”
🌟 Age alone is not a risk factor unless the client is ≥ 25 or ≥ 35, depending on the guideline used.
🌟 Being 20 years old does not meaningfully change insulin resistance or glucose metabolism.
🌟 Stating this would incorrectly imply that young clients are automatically at risk.
🌟 Evidence shows that the most notable risk increase begins around ages 25–30 due to metabolic changes.
🌟 Therefore, this explanation is not accurate or clinically supported.
Want to practice more questions like this?
This question is from NR324.NR329 Exam 1 Assessment which contains 53 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Medical-Surgical
- Answer Choices: 6